Contributions to the study of insanity and its treatment, &c., &c.

  • Clouston, T. S. (Thomas Smith), 1840-1915.
Date:
1863-[1870]
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to the study of insanity and its treatment, &c., &c. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    I am inclined to think I pushed the medicine too far in this case, and subdued the violent excitement too quickly. The prolonged after stage of confusion of mind, and the great fall in temperature, makes me think so; still the sedative effects were here most marked. Melancholia with excitement and hallucination.—M. C—, eet. 60 ; a sempstress, unmarried, who had been insane for about three months. The immediate cause of her insanity is stated to have been a sudden shock which she received from a nephew shouting in her ear that he would kill her. She had brain fever twenty years ago, and is stated to have been rather nervous and irritable ever since. After the shock she got depressed in mind, and began to take fancies that people were going to hang her, that dogs were going to worry her on account of the crimes she imagined she had committed. She got so depressed in mind that she many times attempted to commit suicide by strangling herself. Had been sleepless. No hereditary predis- position to insanity. On admission she was dull in mind, but quite coherent and rational on all points except that she said she was to be hanged. She was short and rather stout; tongue furred; pulse 96, very weak and thready; morning temperature 97-6°; evening temperature 97'2°; weight, 134| lbs. Her pupils are both contracted and her eyes suffused. For the first month she got no medicine. During that time her average morning temperature was 9S-1°, and her evening tempera- ture 97°, and the pulse was 100 and remained weak. She ate pretty well, and gained i>\ lbs. in weight in that time. She did not sleep well. Her delusions remained, and she got more depressed in mind. She was then put on one grain of opium three times a day. She slept better while taking this, but her depression of mind got worse. She had hallucinations of hearing, and after a fortnight the opium had to be given up. While taking it her temperature in the morn- ing was 7° lower than it had been, and in the evening 1° higher, while her pulse was ten beats lower. She ceased to gain in weight after getting the opium. After this, various modes of treatment were adopted, and amongst others she got occasional doses of tincture of cannabis indica; but she continued to get worse and to lose in weight until, at April 1st, 1868, her state was the following:—Is much excited, sleepless, restless by night and day, cannot employ herself in any way, imagines that she is to be hanged every minute, begs every one about her for a ' reprieve/ tries to get forcibly out of the ward door to get one; tries sometimes to commit suicide ; says her brain is ' on fire/ and cries out, ' My head, my head—I 'in confused. I don't know what I'm doing—I'm mad.' Has lost a stone in weight. She still got worse, requiring stimulants to keep her up until the beginning of August, when she was put on drachm doses of bromide